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In Vivo Elongation of the Anterior Cruciate Ligament and Posterior Cruciate Ligament during Knee Flexion
Abstract
Background: Most knowledge regarding cruciate ligament function is based on in vitro experiments. Purpose: To investigate the in vivo elongation of the functional bundles of the anterior cruciate ligament and posterior cruciate ligament during weightbearing flexion. Hypothesis: The biomechanical role of functional bundles of the anterior cruciate ligament and posterior cruciate ligament under in vivo loading is different from that measured in cadavers. Study Design: In vivo biomechanical study. Methods: Elongation of the anterior cruciate ligament and posterior cruciate ligament was measured during a quasi-static lunge using imaging and 3-dimensional computer-modeling techniques. Results: The anterior-medial bundle of the anterior cruciate ligament had a relatively constant length from full extension to 90° of flexion. The posterior-lateral bundle of the anterior cruciate ligament decreased in length with flexion. Both bundles of the posterior cruciate ligament had increased lengths with flexion. Conclusion: The data did not demonstrate the reciprocal function of the 2 bundles of the anterior cruciate ligament or the posterior cruciate ligament with flexion observed in previous studies. Instead, the data suggest that there is a reciprocal function between the anterior cruciate ligament and posterior cruciate ligament with flexion. The anterior cruciate ligament plays a more important role in low-flexion angles, whereas the posterior cruciate ligament plays a more important role in high flexion. Clinical Relevance: Understanding the biomechanical role of the knee ligaments in vivo is essential to reproduce the structural behavior of the ligament after injury (especially for 2-bundle reconstructions) and thus improve surgical outcomes.
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“Recent in vivo measurements showed that both bundles are longest at full 224 knee extension [7, 8, 9, 10].”
From Computational study of kinematics of the anterior cruciate ligament double-bundle structure during passive knee flexion-extension (2020) · cites this paper as [7]
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Metadata
- Authors
- Li, G., DeFrate, L. E., Sun, H., & Gill, T. J.
- Affiliations
- Harvard University (US)
- Corresponding author
- Li, Guoan
- Venue
- The American Journal of Sports Medicine
- Publisher
- SAGE Publications
- Published
- 2004-09
- Volume
- 32
- Issue
- 6
- Pages
- 1415-1420
- ISSN
- 0363-5465 (ISSN-L)
- 1552-3365
- OpenAlex
- W2050751779
- Cited by
- 182
- References
- 33
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 8 · 2023: 8 · 2022: 7 · 2021: 11 · 2020: 10 · 2019: 12 · 2018: 8 · 2017: 6 · 2016: 8 · 2015: 2 · 2014: 10 · 2013: 11 · 2012: 10
- FWCI
- 9.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Keywords
- anterior cruciate ligament, posterior cruciate ligament, ligament elongation, knee flexion, lunge, knee biomechanics, ligament injury, ligament reconstruction
- MeSH terms
- Adult, Biomechanical Phenomena, Computer Simulation, Humans, Knee Injuries, Knee Joint, Magnetic Resonance Imaging, Movement, Anterior Cruciate Ligament, Posterior Cruciate Ligament, Weight-Bearing
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